Interstate medical journal (1917) (14781397214)

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities



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than in the past? There were forty-five answers—thirty-six affirmatives and nine negatives.Among those performing cholecystectomies more often were Bevan andFrazier, 80 to 90 percent; Elting, 60 percent; Gibbon, 50 percent; Clark, 33%percent; Martin, more often, but considers it a more dangerous operation;Deaver, more frequently than formerly, but not so often as many surgeons;Crile, not much more often. In 1907 the Mayos performed 100 cholecystec- Guthrie: Cholecystectomy 765 tomies and 261 cholecystostomies. In 1915, 915 cholecystectomies and but 60cholecystostomies. Some of the men not using cholecystectomy as often ascholecystostomy were Kelly, Bloodgood, Finney, Grant, and Cullen. Question 3: Have the results been better than when simple drainage wasused? Thirty-six men answered yes; seven answered no; two failed to answer.Question 4: In what cases do you consider cholecystectomy the operationof choice? The chief indications for removal given by the majority are any disease of
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Fig. 2.—Infundibulum of the gallbladder lifted up away from the gastrohepatieomentum, exposing cystic duct and artery. the wall of the gallbladder itself or damage to the cystic duct. Three sur-geons prefer cholecystectomy in every case; two, in all cases except thosecomplicated by pancreatic disease; 80 percent advise removal when any dis-ease of the gallbladder wall, with or without stone, is found, mentioning asindications thick-walled, enlarged gallbladders; thick-walled, contracted gall-bladders; adherent gallbladders; adhesions to the pylorus (Lund) ; gangrenousgallbladders; in early malignancy confined to the gallbladder itself. Kehrurges cholecystectomy as a prophylaxis in cases of chronic cholecystitis whichprove rebellious to medical treatment. Several (Mayo, Judd, Lathrop, Gibbon, 766 INTERSTATE MEDICAL JOURNAL and others) call attention to the possibility of systemic joint infection secondaryto disease in the wall of the gallbladder, as pointed out by Rosenow, andadvise